Lengthy quest to restore medical license nears end

Saturday

Herkimer County Public Health Director Gregory O’Keefe hasn’t merely fought to regain the medical license he lost a decade ago.

You could say he’s been on a quest, one that has consumed the Little Falls man and the county he works for.

Herkimer County Public Health Director Gregory O’Keefe hasn’t merely fought to regain the medical license he lost a decade ago.

You could say he’s been on a quest, one that has consumed the Little Falls man and the county he works for.

His efforts are about to bear fruit with his license becoming fully restored next month. Along the way, his journey has touched many lives and raised many questions.

O’Keefe has blamed his past medical errors on the health effects of a 40-foot fall he took from a roof. He’s also accused the leader of Bassett Healthcare Network of deep-sixing his medical career over O’Keefe’s allegations of fraud years ago at a Herkimer clinic.

More recently, he’s told the state he needs his medical license back to do his job well, even though Herkimer County officials have maintained that was not the case.

Throughout this saga, county leaders have extolled O’Keefe’s skills and vouched for his character as he reapplied for his medical license. And his friends in county and state government have gone to bat for him at key moments, even helping pass a state law two years ago to make it less likely someone would lose their medical license over the same circumstances in the future.

“I really believe he’s a good man and does a good job,” said county Administrator James Wallace, who, like many other local officials, refers to O’Keefe as “Doc.”

Yet Herkimer County also made a $175,000 payout several years ago to Diane Cusworth, a former county nurse who’d sued after O’Keefe got the public health director position. She said she was more qualified than O’Keefe and had been overlooked in the past.

And within the last year, the county was forced to discipline O’Keefe. According to documents obtained by the O-D, O’Keefe has made inappropriate comments to employees, demonstrated poor clinical judgment and failed to organize his department properly.

The county subsequently required O’Keefe to undergo sensitivity training and to attend courses on business and organizational matters.

Today, O’Keefe talks like a man who has weathered a storm successfully.

“You learn from a painful experience,” O’Keefe said. “That experience certainly is part of what you are in the future. There are a lot of people who stumble and are able to carry on afterwards. I feel lucky I’ve been able to carry on.”

County clinic planned?

O’Keefe has been practicing medicine since 2008 in New York state under probationary conditions. Those stipulations include having his practice monitored by Dr. Deepak Buch, a physician at Little Falls Hospital. O’Keefe has been working at the hospital part time, using vacation leave from his county job.

The county also might be planning to draw on O’Keefe’s medical skills once his license is fully restored. Creating a county clinic where O’Keefe could practice medicine has been discussed, Wallace said.

O’Keefe, who will earn $71,032 this year as county public health director, already serves as the county jail physician – a job that he’s done for free since last year. ‘Pervasive deficiencies’

What disciplinary actions have taken place against O’Keefe?

* MAINE: In 1996, he settled a Medicaid fraud violation, which he blamed on poor record keeping at his Maine practice. The violation cost him $7,500 in penalties.

* NEW YORK: In 2000, he lost his New York medical license on charges of professional misconduct, negligence and incompetence stemming from nine separate patients he treated in the mid-1990s at a Bassett clinic in Herkimer.

O’Keefe hit a patient’s lung while performing an injection and failed to transport the patient to the hospital, state Education Department licensing records show. Other cases involved misreading test results, failing to consult specialists and making other misdiagnoses, the state documents show.

The state Office of Professional Medical Conduct, which operates under the auspices of the state Department of Health, ruled in 2000 that revoking O’Keefe’s license was the only measure that would protect the public adequately.

O’Keefe had “fundamental and pervasive deficiencies in his medical knowledge” and “little insight into his problems,” the office determined.

By that time, he’d been a doctor for a quarter century.

Evacuations from island

A graduate of Princeton University and Johns Hopkins University School of Medicine, O’Keefe began his medical career in Maine in 1975, practicing in the town of Vinalhaven – an island community of 1,200 accessible only by boat and air.

Maine documents describe the work he did in his practice as strenuous and risky. He participated yearly in more than 200 patient evacuations to the mainland by land and sea.

His nearly 20 years there would be a formative time in his career that shaped the way he cared for patients and contributed to the mistakes made at Bassett, a state Education Department committee of physicians would say in 2008.

“His experience in Maine may have led to a tendency to eschew collaboration when it was available and needed in a hospital setting,” according to state records. “The applicant acknowledged that his desire to prove himself in a hospital setting may have led to overwork and the errors that occurred” in New York state.

By 1994, he moved to the Mohawk Valley to be near his wife’s family. He took a job as medical director at the Bassett clinic.

But shortly after the move, his life became more complicated.

O’Keefe would suffer the fall off the roof of his Little Falls home. Months later, he was back at work at Bassett, getting around with the help of a wheelchair and walker.

He has since argued that the fall and his subsequent rushed return to work triggered a thyroid condition, which made him tired, and that went undiagnosed until 1998.

“He had indeed, been feeling tired … and at times, felt that he was in a ‘fog,’” according to 2006 testimony on behalf of O’Keefe before the state Office of Professional Responsibility, which operates under the auspices of the state Education Department.

Bassett allegations

Yet at another point, O’Keefe would point a finger at the administration of Bassett for his license woes.

In multiple documents from both Maine and New York state, O’Keefe claimed that Bassett Healthcare Network CEO and President William Streck reported O’Keefe’s medical cases to the state Department of Health.

According to the documents, this occurred in retaliation for O’Keefe pointing out alleged Medicaid and Medicare fraud at Bassett’s clinic in Herkimer and for O’Keefe’s later decision to leave Bassett.

“I will fight to my death against any unscrupulous hospital CEO’s personal empire building,” O’Keefe said in a 2002 New York state Assembly public hearing on a law that would alter procedures by which a medical license could be taken away.

This defense also showed up in a 2003 proceeding in the Maine Board of Licensure in Medicine. That board concluded that political unfairness might have played a role in O’Keefe’s problems in New York, a board spokesman said.

“O’Keefe terminated his employment with Bassett since he was concerned by what he felt were fraudulent billing practices and informed the chief executive officer of that allegation in September 1997,” the Maine document states. “In return, several cases were brought forward by Bassett questioning the care that Dr. O’Keefe rendered to his patients.”

Bassett representatives disputed the assertions.

“The statements Dr. O’Keefe made following the revocation of his license are false, seriously misrepresent Bassett’s role, and are not consistent with the fact of the case,” Bassett spokeswoman Karen Huxtable-Hooker said in a written statement.

Streck would not consent to an interview. But he said of O’Keefe in the Bassett statement, “We wish him well and share with him a commitment to the health needs of the residents of this region.”

When asked about the allegations he made against Bassett, O’Keefe said he stands by what he said. But he’s moved on from what he considers a time of lost battles.

“I certainly respect and consider Dr. Streck to have been a good friend of mine,” O’Keefe said. “That’s why this is painful and remains painful.”

Attorney Bart Carrig, of Little Falls, who has represented O’Keefe in state matters, called the situation that caused his client to lose his license “a coincidence of things.”

“Dr. O’Keefe is just a loved physician in the community,” Carrig said. “That is really what made the difference when he made the application for reinstatement several years ago.”

Powerful backing

In 2005, O’Keefe applied to the state seeking reinstatement of his medical license.

“He believes that he could perform his duty as director of public health even more efficiently if he were again licensed to practice medicine because he has not been able to perform all of the duties that a public health director should do without a medical license,” his application records state.

That’s a position that Herkimer County officials strenuously had denied when O’Keefe took the job eight years ago.

In an interview last week, O’Keefe said it was an exaggeration on his part in his application effort.

“Perhaps that was a little too grand,” O’Keefe said. “When it really comes right down to it, I think I feel better about being able to do my duties with that licensure.”

O’Keefe’s road back to getting his license was aided by more than a dozen state, county and medical officials vouching in recent years for his character, his medical skills and his professional growth.

Among them: state Sen. James Seward, R-Milford; Assemblyman Marc Butler, R-Newport; Wallace; and attorney George Aney, a member of the Herkimer County and New York state Republican committees.

Aney, who said he met O’Keefe through his volunteer efforts, said O’Keefe was treated unfairly in the state disciplinary proceedings that cost him his medical license.

After O’Keefe lost his license, Aney accompanied him on a trip to Albany to speak with state Department of Health officials about what had occurred.

“I am so convinced of his medical competence and integrity that I think that license should be returned to him at the soonest possible moment,” Aney said.

Seward and Butler backed legislation signed into law in 2008 intended to reform the process by which O’Keefe originally lost his license. The two legislators even presented O’Keefe with a personal copy of the law at a county Legislature meeting last year.

The bill required the Office of Professional Medical Conduct, an arm of the state Department of Health, to obtain a physician’s medical records if those records are relevant. It also allowed new evidence that could change the outcome of a licensing proceeding to be entered when it becomes available.

“Dr. O’Keefe’s case pointed to some glaring problems in the process, and we used his case as an example to help spur some change,” Seward said. “I’m most impressed by the fact that in the face of this professional challenge, Greg O’Keefe did not cut and run. He stayed in the community.”

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